Monday, February 01, 2010

Crispian, Cramp and the DVT

There are always a few people who think that, just because they swim faster than everyone else, they don't need to look where they're going.

One huge, burly bloke ploughs right down the middle of the lane every morning, instead of swimming in a loop as he should do. This morning he nearly crashed right into me, simply because he thought it was fine to do backstroke at top speed, veering about all over the place.

I managed to dodge him by doing a swift manoeuvre out of the way - - - and then realised that this strange, fast movement was giving me cramp in my bad leg.

My right leg is prone to getting cramp because the circulation's a bit rubbish. I had a deep-vein thrombosis in it, in 1984. My first baby had been born prematurely and died, and then I'd been very ill, and on the day that they were going to let me out of hospital I got a pain in my leg. They did a test to see if there was a blood clot (injecting dye into the top of my foot ewwwwwwww) but it was inconclusive.

I went home and my leg swelled up like a balloon, and turned white, the classic sign of a deep-vein thrombosis. A young and inexperienced GP turned up and didn't have a clue what it was and he had the inconclusive test result in his hand, and never thought to think "The test result must be wrong".

I had a swollen leg, agonising pain, a recent pregnancy (which can make people prone to DVT) and a family history of DVT - my father had had one. So other than writing THIS LEG HAS A THROMBOSIS IN IT in indelible ink on my leg, I don't know what more I could have done to demonstrate the classic symptoms, and I don't know why he couldn't diagnose it - - but he didn't.

Probably because he was an idiot, or because he wasn't paying attention on the day they did DVTs at medical school.

(His name was Dr Lloyd. He emigrated to Australia. I hope it was because of me. Sorry, Australia).

So for six weeks I couldn't walk much at all because of the agonising pain, which was like the worst toothache in the world, but in my leg. And finally a bit of the blood clot broke away and settled nicely in my lung, which nearly killed me but luckily (for me at least) didn't. And because I now couldn't BREATHE they took it a bit more seriously and a doctors came who wasn't Dr Lloyd and panicked a lot and finally got me into hospital.

But by then the DVT had done a lot of damage and my leg's never been the same since.

For years it hurt all the time - - actually I think it still hurts quite a bit, but I've kind of learned to screen it out so I don't notice it unless I think about it.

But it's prone to getting cramp, and when it does it's back to the same pain I had when I had the DVT, and it makes me panic a bit because the blood supply's not very good so it can't uncramp itself for ages and I have to hop around and scream AAAARGH AAAAARGH AAAAAAAAARGH and I feel a right fool.

This morning, however, I got to it in time - - stood up, stretched my leg out and it uncramped itself. But when it does this it takes a day or so to recover, so I'll be giving the swimming a miss tomorrow morning I think, which is a pity.

So, what's the point of this jolly little anecdote other than for me to have a good whinge about it?

Well, there were several knock-on effects from this idiot doctor. Firstly, of course, my near-death experience and the permanent severe damage to my leg. Secondly, I should like people who plough up and down swimming pools without looking and consider that they have a God-given right to do so, to be warned twice and then banned from the pool forever!

And finally, there is how I feel when I encounter medical students like Crispian. (That wasn't his name, but it was that kind of name).

Crispial turned up late to class last week, looking - and smelling - as though he'd just got out of bed. Had he brought a pen? No. Or a piece of paper, perchance? No. Because - - and I quote - - "I didn't think I'd have to write anything down. I thought this session would just be a ten-minute chat or something."

WHY ON EARTH WOULD YOU THINK THAT, MORON? resounded through my head.

I wasn't running the class so I couldn't say anything, though I sent in some strongly-worded written feedback afterwards.

I don't want you to think that, these days, this kind of thing is common. Most of the medical students I meet are committed, intelligent, hard-working, caring.

But some aren't. To me, every medical student who isn't paying attention is another Dr Lloyd in the making. And up with this I will not put.


Blogger Yorkshire Pudding said...

In an ideal world, Dr Lloyd would have been carpetted and given some retraining but in this less than ideal world he's probably living in a mansion in the suburbs of Melbourne and being paid a king's ransom - most likely totally unaware of the lasting results of his early incompetence.

12:51 am  
Anonymous Writeous Indignation said...

Medical students! After 13 years in the NHS I was left thinking that it's the SHO's you have to worry about - you know, the ones who are meant to know better!
And the flashier the waistcoat, the worse they are!;-)
How happy the world would be, if your story of medical imcompetence was so rare that people would say "NO! Really?" instead of sighing and then countering with their own...

9:53 am  
Blogger Daphne said...

YP - I fear you may be right. But nowadays to be a GP is at least another three years' training once you've qualified and there should be no excuse for missing a relatively common diagnosis like this - especially when there are all the symptoms present.
Writeous Indignation - yes, I work with SHOs too and sometimes by then they think they know the lot - - oh, and they so don't! I'm just grateful that the work I do with medical students in Communication Skills is one tiny step towards getting things better.

9:58 am  

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